Sleep-related problems are among the most common issues seen by a pediatrician, and for good reason—poor sleep habits can lead to behavioral, educational, social and health problems. Fortunately for parents, many childhood sleep problems can be recognized early and treated successfully.
"Many behavioral problems we see in children are the result of sleep problems. Once you address sleep, these problems, be it moodiness or depression or even ADHD, may disappear," says Dr. Haviva Veler, director of the new Weill Cornell Pediatric Sleep Center and a pediatrician at the Komansky Center for Children's Health at NewYork-Presbyterian Hospital.
The Pediatric Sleep Center is staffed by a multidisciplinary team of pediatricians and pediatric specialists in the areas of sleep, pulmonology, otolaryngology (ENT), neurology and psychology to address a range of sleeping issues, from teaching parents techniques to help babies sleep during the night to more serious problems, such as sleep apnea and insomnia. After conducting comprehensive testing in fully equipped and child-friendly sleep labs, the team develops individualized treatment plans for children, which may include devices that support breathing during sleep, medications, surgery or behavioral therapy.
According to Dr. Veler, a board-certified pediatrician, pediatric pulmonologist and sleep medicine specialist, "Parents should promote good sleep patterns in their children and address any concerns with a pediatrician or sleep specialist to not only alleviate any behavioral problems, but to also set their child on the road to educational success and physical health."
Sleep disorders in children are often different from those that affect adults, and therefore it is important for parents to be attuned to their child's sleep habits.
Age-by-age sleep concerns
In infants up to 1 year old, the main concern for parents is getting their baby to sleep through the night. To help babies fall asleep on their own, parents should keep a consistent schedule for bedtime and naps and choose a good sleep-onset association—an object or action that the infant relies on to fall asleep, such as a blanket, soothing music or being rocked or fed. After 16 months, however, parents can usually stop nighttime feedings. If your child has difficulties sleeping through the night or snores excessively, consult a sleep specialist or pediatrician as this may be a sign of sleep apnea.
In toddlers (ages 1 to 3 years old), common issues are night terrors and nightmares. These events are normal, and parents can simply discuss the details of the nightmare and identify any avoidable triggers, such a scary story or movie. Another problem—refusal to go to sleep or delaying bedtime—can be minimized by keeping a consistent bedtime routine and using soothing and relaxing activities.
In preschoolers, the most common sleep problem, sleep apnea, develops in 2-3 percent of children. About 10 percent of children snore, but if it is loud and happens more than three nights a week, sleep apnea may be the culprit. This requires a visit to the doctor. Other symptoms associated with sleep apnea include difficulty breathing or even choking while sleeping, frequently waking up during the night, hypertension, hyperactivity, learning problems and bedwetting.
"Sleep apnea in children—that is, obstruction of the upper airway—differs from adult apnea," says Dr. Veler, who is also an assistant professor of pediatrics at Weill Cornell Medical College.
"The reasons for sleep apnea in adults usually relates to obesity. In children, it is actually more prevalent in low-weight children and is caused by large tonsils and adenoids that normally shrink and disappear as the child ages."
In school-aged children and adolescents, sleep deprivation is a common issue, often caused by social obligations, increased school work, and entertainment distractions, such as computers, TV and cell phones. Sleep deprivation can cause problems with attention, memory, cognitive function and school performance. In adolescents, caffeine, smoking and drinking can also cause sleep problems, plus a host of other serious health issues.
Other sleep problems that may arise during adolescence include narcolepsy—marked by excessive daytime sleepiness and falling asleep during the day—and restless leg syndrome, a condition with very distinct symptoms involving discomfort in the legs. These conditions should be addressed by a physician.
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For more information on the new sleep center, located at 425 East 61st St. in Manhattan, visit nyp.org/komansky/patient_care/centers_programs/sleep/ or call 646-962-3410.